Markers of poor outcome in patients with acute hypoxemic respiratory failure

Won Il Choi, Esmeralda Shehu, So Yeon Lim, Shin Ok Koh, Kyeongman Jeon, Sungwon Na, Chae Man Lim, Young Joo Lee, Seok Chan Kim, Ick Hee Kim, Je Hyeong Kim, Jae Yeol Kim, Jaemin Lim, Chin Kook Rhee, Sunghoon Park, Ho Cheol Kim, Jin Hwa Lee, Ji Hyun Lee, Jisook Park, Younsuck KohGee Young Suh

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: This study described the acute hypoxemic respiratory failure (AHRF) population and identified potential modifiable markers of outcome. Methods: A prospective, multicenter study was performed in 22 intensive care units (ICUs). The clinical outcomes of patients with acute respiratory distress syndrome (ARDS) were compared to the outcomes in patients with non-ARDS AHRF, and a propensity score matched analysis was performed. Results: A total 837 patients with an arterial oxygen tension/fraction of inspired oxygen ratio (Pao2/Fio2) less than 300 mm Hg on ICU admission were included. Of these, 163 patients met the criteria defining ARDS, whereas the remaining 674 patients who had unilateral or no pulmonary opacities were classified as non-ARDS AHRF. Baseline Pao2/Fio2 ratio, thrombocytopenia, increased positive end-expiratory pressure (PEEP) were significantly associated with the 60-day mortality in hypoxemic respiratory failure after multivariate analysis. However, ARDS was not associated with increased 60-day mortality when independent predictors for the 60-day mortality and propensity score were controlled. In the case-control study, the 60-day mortality rate was 38.6% in the ARDS group and 32.3% in the non-ARDS AHRF group. In both patients with ARDS and non-ARDS AHRF, the mortality rate increased proportionally to a lower baseline Pao2/Fio2. Conclusion: Lower baseline oxygenation (Pao2/Fio2) is a poor prognostic marker in acute hypoxemic respiratory failure.

Original languageEnglish
Pages (from-to)797-802
Number of pages6
JournalJournal of Critical Care
Volume29
Issue number5
DOIs
Publication statusPublished - 2014 Jan 1

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Adult Respiratory Distress Syndrome
Respiratory Insufficiency
Mortality
Propensity Score
Intensive Care Units
Oxygen
Positive-Pressure Respiration
Thrombocytopenia
Multicenter Studies
Case-Control Studies
Arterial Pressure
Multivariate Analysis
Prospective Studies
Lung

Keywords

  • Acute respiratory failure
  • ARDS
  • Hypoxemia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Choi, W. I., Shehu, E., Lim, S. Y., Koh, S. O., Jeon, K., Na, S., ... Suh, G. Y. (2014). Markers of poor outcome in patients with acute hypoxemic respiratory failure. Journal of Critical Care, 29(5), 797-802. https://doi.org/10.1016/j.jcrc.2014.05.017

Markers of poor outcome in patients with acute hypoxemic respiratory failure. / Choi, Won Il; Shehu, Esmeralda; Lim, So Yeon; Koh, Shin Ok; Jeon, Kyeongman; Na, Sungwon; Lim, Chae Man; Lee, Young Joo; Kim, Seok Chan; Kim, Ick Hee; Kim, Je Hyeong; Kim, Jae Yeol; Lim, Jaemin; Rhee, Chin Kook; Park, Sunghoon; Kim, Ho Cheol; Lee, Jin Hwa; Lee, Ji Hyun; Park, Jisook; Koh, Younsuck; Suh, Gee Young.

In: Journal of Critical Care, Vol. 29, No. 5, 01.01.2014, p. 797-802.

Research output: Contribution to journalArticle

Choi, WI, Shehu, E, Lim, SY, Koh, SO, Jeon, K, Na, S, Lim, CM, Lee, YJ, Kim, SC, Kim, IH, Kim, JH, Kim, JY, Lim, J, Rhee, CK, Park, S, Kim, HC, Lee, JH, Lee, JH, Park, J, Koh, Y & Suh, GY 2014, 'Markers of poor outcome in patients with acute hypoxemic respiratory failure', Journal of Critical Care, vol. 29, no. 5, pp. 797-802. https://doi.org/10.1016/j.jcrc.2014.05.017
Choi, Won Il ; Shehu, Esmeralda ; Lim, So Yeon ; Koh, Shin Ok ; Jeon, Kyeongman ; Na, Sungwon ; Lim, Chae Man ; Lee, Young Joo ; Kim, Seok Chan ; Kim, Ick Hee ; Kim, Je Hyeong ; Kim, Jae Yeol ; Lim, Jaemin ; Rhee, Chin Kook ; Park, Sunghoon ; Kim, Ho Cheol ; Lee, Jin Hwa ; Lee, Ji Hyun ; Park, Jisook ; Koh, Younsuck ; Suh, Gee Young. / Markers of poor outcome in patients with acute hypoxemic respiratory failure. In: Journal of Critical Care. 2014 ; Vol. 29, No. 5. pp. 797-802.
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abstract = "Purpose: This study described the acute hypoxemic respiratory failure (AHRF) population and identified potential modifiable markers of outcome. Methods: A prospective, multicenter study was performed in 22 intensive care units (ICUs). The clinical outcomes of patients with acute respiratory distress syndrome (ARDS) were compared to the outcomes in patients with non-ARDS AHRF, and a propensity score matched analysis was performed. Results: A total 837 patients with an arterial oxygen tension/fraction of inspired oxygen ratio (Pao2/Fio2) less than 300 mm Hg on ICU admission were included. Of these, 163 patients met the criteria defining ARDS, whereas the remaining 674 patients who had unilateral or no pulmonary opacities were classified as non-ARDS AHRF. Baseline Pao2/Fio2 ratio, thrombocytopenia, increased positive end-expiratory pressure (PEEP) were significantly associated with the 60-day mortality in hypoxemic respiratory failure after multivariate analysis. However, ARDS was not associated with increased 60-day mortality when independent predictors for the 60-day mortality and propensity score were controlled. In the case-control study, the 60-day mortality rate was 38.6{\%} in the ARDS group and 32.3{\%} in the non-ARDS AHRF group. In both patients with ARDS and non-ARDS AHRF, the mortality rate increased proportionally to a lower baseline Pao2/Fio2. Conclusion: Lower baseline oxygenation (Pao2/Fio2) is a poor prognostic marker in acute hypoxemic respiratory failure.",
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T1 - Markers of poor outcome in patients with acute hypoxemic respiratory failure

AU - Choi, Won Il

AU - Shehu, Esmeralda

AU - Lim, So Yeon

AU - Koh, Shin Ok

AU - Jeon, Kyeongman

AU - Na, Sungwon

AU - Lim, Chae Man

AU - Lee, Young Joo

AU - Kim, Seok Chan

AU - Kim, Ick Hee

AU - Kim, Je Hyeong

AU - Kim, Jae Yeol

AU - Lim, Jaemin

AU - Rhee, Chin Kook

AU - Park, Sunghoon

AU - Kim, Ho Cheol

AU - Lee, Jin Hwa

AU - Lee, Ji Hyun

AU - Park, Jisook

AU - Koh, Younsuck

AU - Suh, Gee Young

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: This study described the acute hypoxemic respiratory failure (AHRF) population and identified potential modifiable markers of outcome. Methods: A prospective, multicenter study was performed in 22 intensive care units (ICUs). The clinical outcomes of patients with acute respiratory distress syndrome (ARDS) were compared to the outcomes in patients with non-ARDS AHRF, and a propensity score matched analysis was performed. Results: A total 837 patients with an arterial oxygen tension/fraction of inspired oxygen ratio (Pao2/Fio2) less than 300 mm Hg on ICU admission were included. Of these, 163 patients met the criteria defining ARDS, whereas the remaining 674 patients who had unilateral or no pulmonary opacities were classified as non-ARDS AHRF. Baseline Pao2/Fio2 ratio, thrombocytopenia, increased positive end-expiratory pressure (PEEP) were significantly associated with the 60-day mortality in hypoxemic respiratory failure after multivariate analysis. However, ARDS was not associated with increased 60-day mortality when independent predictors for the 60-day mortality and propensity score were controlled. In the case-control study, the 60-day mortality rate was 38.6% in the ARDS group and 32.3% in the non-ARDS AHRF group. In both patients with ARDS and non-ARDS AHRF, the mortality rate increased proportionally to a lower baseline Pao2/Fio2. Conclusion: Lower baseline oxygenation (Pao2/Fio2) is a poor prognostic marker in acute hypoxemic respiratory failure.

AB - Purpose: This study described the acute hypoxemic respiratory failure (AHRF) population and identified potential modifiable markers of outcome. Methods: A prospective, multicenter study was performed in 22 intensive care units (ICUs). The clinical outcomes of patients with acute respiratory distress syndrome (ARDS) were compared to the outcomes in patients with non-ARDS AHRF, and a propensity score matched analysis was performed. Results: A total 837 patients with an arterial oxygen tension/fraction of inspired oxygen ratio (Pao2/Fio2) less than 300 mm Hg on ICU admission were included. Of these, 163 patients met the criteria defining ARDS, whereas the remaining 674 patients who had unilateral or no pulmonary opacities were classified as non-ARDS AHRF. Baseline Pao2/Fio2 ratio, thrombocytopenia, increased positive end-expiratory pressure (PEEP) were significantly associated with the 60-day mortality in hypoxemic respiratory failure after multivariate analysis. However, ARDS was not associated with increased 60-day mortality when independent predictors for the 60-day mortality and propensity score were controlled. In the case-control study, the 60-day mortality rate was 38.6% in the ARDS group and 32.3% in the non-ARDS AHRF group. In both patients with ARDS and non-ARDS AHRF, the mortality rate increased proportionally to a lower baseline Pao2/Fio2. Conclusion: Lower baseline oxygenation (Pao2/Fio2) is a poor prognostic marker in acute hypoxemic respiratory failure.

KW - Acute respiratory failure

KW - ARDS

KW - Hypoxemia

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